Article Text

Original research
Respiratory and allergic outcomes among 5-year-old children exposed to pesticides
  1. Jessica Y Islam1,2,
  2. Jane Hoppin1,2,
  3. Ana M Mora3,4,
  4. Manuel E Soto-Martinez5,
  5. Leonel Córdoba Gamboa3,
  6. Jorge Ernesto Peñaloza Castañeda3,
  7. Brian Reich1,6,
  8. Christian Lindh7,
  9. Berna van Wendel de Joode3
  1. 1Center for Human Health and the Environment, North Carolina State University, Raleigh, North Carolina, USA
  2. 2Department of Biological Sciences, North Carolina State University, Raleigh, North Carolina, USA
  3. 3Infants' Environmental Health (ISA) Program, Central American Institute for Studies on Toxic Substances (IRET), Universidad Nacional, Heredia, Costa Rica
  4. 4Center for Environmental Research and Children's Health (CERCH), University of California, Berkeley, California, USA
  5. 5Respiratory Department, Hospital Nacional de Niños, San Jose, Costa Rica
  6. 6Department of Biostatistics, North Carolina State University, Raleigh, North Carolina, USA
  7. 7Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden
  1. Correspondence to Professor Berna van Wendel de Joode, Universidad Nacional, Heredia 40101, Costa Rica; berendina.vanwendel.dejoode{at}una.cr

Abstract

Background Little is known about the effects of pesticides on children’s respiratory and allergic outcomes. We evaluated associations of prenatal and current pesticide exposures with respiratory and allergic outcomes in children from the Infants’ Environmental Health Study in Costa Rica.

Methods Among 5-year-old children (n=303), we measured prenatal and current specific gravity-corrected urinary metabolite concentrations of insecticides (chlorpyrifos, pyrethroids), fungicides (mancozeb, pyrimethanil, thiabendazole) and 2,4-D. We collected information from caregivers on respiratory (ever doctor-diagnosed asthma and lower respiratory tract infections (LRTI), wheeze and cough during last 12 months) and allergic (nasal allergies, itchy rash, ever eczema) outcomes. We fitted separate multivariable logistic regression models for high (≥75th percentile (P75)) vs low (<P75) metabolite concentrations with respiratory and allergic outcomes. We also ran models including metabolite concentrations as continuous exposure variables.

Results Children’s respiratory outcomes were common (39% cough, 20% wheeze, 12% asthma, 5% LRTI). High current pyrethroid metabolite concentrations (∑pyrethroids) were associated with wheeze (OR=2.37, 95% CI 1.28 to 4.34), itchy rash (OR=2.74, 95% CI 1.33 to 5.60), doctor-diagnosed asthma and LRTI. High current ethylene thiourea (ETU) (specific metabolite of mancozeb) was somewhat associated with LRTI (OR=2.09, 95% CI 0.68 to 6.02). We obtained similar results when modelling ∑pyrethroids and ETU as continuous variables. We saw inconsistent or null associations for other pesticide exposures and health outcomes.

Conclusions Current pyrethroid exposure may affect children’s respiratory and allergic health at 5 years of age. Current mancozeb exposure might contribute to LRTI. These findings are important as pyrethroids are broadly used in home environments and agriculture and mancozeb in agriculture.

  • asthma epidemiology
  • paediatric asthma
  • respiratory infection

Data availability statement

Data are available upon request. Deidentified participant data are stored in a secure server by the ISA study team. Please contact the corresponding author for interest in potential data access.

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This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.

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Data availability statement

Data are available upon request. Deidentified participant data are stored in a secure server by the ISA study team. Please contact the corresponding author for interest in potential data access.

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Footnotes

  • Twitter @bernavanwendel

  • Correction notice This article has been corrected since it was first published. The open access licence has been updated to CC BY.

  • Contributors JYI: analysis and interpretation of data for this paper, drafting the paper. Final approval of the version to be published. Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. JH: conception or design of the paper, and the acquisition, analysis, and interpretation of data for this paper, revising it critically for important intellectual content. Final approval of the version to be published. Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. Funding acquisition, project administration. AMM: contributions to the conception or design of this paper, revising it critically for important intellectual content. Final approval of the version to be published. Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. MES-M: contributions to the conception or design of the work, revising it critically for important intellectual content. Final approval of the version to be published. Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. LCG: contributions to the acquisition of data for this study, revising it critically for important intellectual content. Final approval of the version to be published. Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. JEPC: contributions to the data analysis for this study, revising the paper critically for important intellectual content. Final approval of the version to be published. Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. BR: contributions to the data analysis for this study, revising it critically for important intellectual content. Final approval of the version to be published. Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. CL: responsible for the chemical analysis of biomarkers for this study. Revising the paper critically for important intellectual content. Final approval of the version to be published. Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. BvWdJ: conception or design of this paper, and the acquisition, analysis, and interpretation of data for the paper. Drafting parts of this paper and revising it critically for important intellectual content. Final approval of the version to be published. Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved, funding acquisition, project administration, responsible for the overall content as guarantor.

  • Funding This publication was made possible by research supported by grant numbers: PO1 1 05 296–001 (IDRC); 2010–1211, 2009–2070, and 2014–01095 (Swedish Research Council Formas); R21 ES025374 (NIEHS); and R24 ES028526 (NIEHS).

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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